Is there any disability for chronic pancreatitis?

Chronic pancreatitis is a serious disease that develops for various reasons. As a result of a long-term inflammatory process in the pancreas, atrophic processes begin, the replacement of parenchymal glandular tissue with connective tissue structures. In connection with the development of pronounced dysfunctions of the gland, many patients are concerned about the question of whether they are entitled to disability due to pancreatitis, how long they can be on sick leave, and other issues related to the examination of disability for this pathology.

Ability to work with pancreatitis

Depending on the severity of the disease, the time of hospital treatment, the effectiveness of this treatment and further prognosis, the duration of the patient’s temporary disability is determined.

Is it possible to work with pancreatitis?

Acute reactive pancreatitis or exacerbation of chronic inflammation of the pancreas is accompanied by severe symptoms of pain, dyspeptic, intoxication syndrome:

• severe pain in the abdomen of a girdle nature, radiating to the chest, back,
• nausea, uncontrollable vomiting, which does not alleviate the patient’s condition,
• increased gas formation in the abdomen, causing bloating,
• profuse diarrhea,
• increase in body temperature,
• general weakness,
• lowering blood pressure,
• pale skin, cold sweat,
• dizziness, headache.

In such a condition, the patient is absolutely unable to work, he needs immediate medical attention: he must be admitted to the hospital and undergo a course of treatment. Treatment at home for this condition is contraindicated.

After stopping the attack, completing a course of full therapy, and subsiding inflammation of the pancreas, the stage of stable, long-term remission of pancreatitis is reached. This means the patient’s ability to work is restored, and he can return to his usual work, subject to all the doctor’s recommendations on lifestyle and nutrition.

How long does sick leave with pancreatitis last?

With the development of acute pancreatitis, the patient is usually admitted to the surgical, therapeutic or gastroenterological department of a multidisciplinary hospital, where the attending physician writes him out a primary certificate of incapacity (sick leave) for the entire stage of inpatient treatment. After discharge from the hospital, sick leave for pancreatitis is extended by a doctor at the clinic, with whom the patient is subsequently observed and treated on an outpatient basis.

With conservative therapy, temporary disability usually lasts from 14 days to 3 months. How many days the patient will spend on sick leave depends on the severity of pancreatitis.

If an operation has been performed, the duration of sick leave is determined taking into account the type of surgical intervention, the effectiveness of such treatment and the condition of the pancreas (the degree of decrease in the functional activity of the organ).

Many people are interested in whether the patient is given disability after pancreatic surgery. Here the effect obtained after surgical treatment should be taken into account. In case of a favorable prognosis for the restoration of pancreatic function, the temporary disability certificate can be extended up to 10 months.

If the operation turns out to be ineffective or the functions of the organ are irreversibly impaired, then the sick leave is extended to a maximum of 120 days. Then the patient is sent for a medical and social examination (MSE) to determine his disability group, since the patient will no longer be able to work fully at his previous place of work and will no longer be able to fully restore his health.

Forms of disease severity

Depending on how many times a year exacerbations develop, the severity of pancreatitis, and the presence of complications, different stages of the chronic inflammatory process are diagnosed:

• The first stage is characterized by the development of exacerbations of the disease no more than 2 times per year. The average duration of the exacerbation period is about 2 weeks. Data from laboratory tests that determine the functional state of the gland and instrumental studies (ultrasound) are within normal limits.
• The second stage of a chronic disease is established when the frequency of attacks is up to 5 times per year, the duration of acute conditions is up to 6 weeks. At this stage of the disease, a moderate decrease in the exocrine function of the pancreas is determined - a decrease in the secretion of bicarbonates and digestive enzymes (lipase, trypsin, amylase). This leads to disruption of food digestion and nutrient absorption. The endocrine function of the organ often suffers - insulin production decreases, which leads to the development of latent diabetes mellitus. Laboratory examination indicators indicate these disorders, and ultrasound of the abdominal organs reveals signs of chronic pancreatitis and cholecystitis.
• The third stage of pancreatitis is associated with the development of attacks more than 5 times in 1 year. The duration of exacerbation at this stage of the disease is up to 3 months. Blood, urine, and stool tests show signs of deterioration in the exocrine and endocrine activity of the gland. Clinically – serious disturbance of digestive processes, weight loss, symptoms of pancreatogenic diabetes. Based on the results of instrumental examination methods, complications of chronic inflammatory processes in the pancreas and gall bladder are revealed - stones in the main pancreatic duct, cysts in the gland tissues, signs of internal bleeding, venous thrombosis, calculous cholecystitis.

Indications for MSE and research methods

Chronic pancreatitis is a serious disease that leads to disruption of the gastrointestinal tract and digestive system. Damage to the pancreas can provoke endocrine disorders in the form of diabetes mellitus and other pathologies.

For a mild course of the disease, it is typical that patients remain able to work. But heavy physical activity and contact with industrial chemicals are contraindicated for this group of patients. In this case, a mandatory change in working conditions is required.

In case of chronic pancreatitis, a referral for a medical and social examination should be given if the patient has stages 2 and 3 of the pathological process. In other words, exacerbations occur up to 5 or more than 5 times every 12 months.

When the picture is complemented by a moderate or severe disturbance in the production of digestive enzymes, an increase in the concentration of sugar in the blood, inflammation of the gallbladder (cholecystitis) and other negative consequences of the disease.

Is there any disability for chronic pancreatitis? The answer is yes. The law provides for disability in the following cases:

• History of frequent internal bleeding.
• After surgery due to moderate or severe digestive dysfunction.
• Thrombosis of the veins of the lower extremities.
• Disorder of the pelvic organs.

If there are complications described, the attending physician gives a referral for a medical and social examination. It involves conducting standard research. Scroll:

1. Routine tests. The activity of digestive enzymes in the body is studied, and the concentration of amylase in urine is determined.
2. The activity of enzymes is studied on an empty stomach and with a load in the duodenum, and a coprogram is performed.
3. X-ray of the duodenum and stomach.
4. Staub-Traugott test with double sugar load.
5. Ultrasound of the pancreas, liver, gallbladder, bile ducts.
6. Computed tomography can reveal the presence of stones in the pancreatic duct - calculous pancreatitis.

Medical and social examination of the ability to work of patients who have undergone surgery is more complex. Because it is necessary to take into account the achieved results - whether it was possible to reduce pain, improve the outflow of pancreatic juice, restore the functionality of the pancreas, close fistulas, eliminate pseudocysts, etc.

It is important to take into account the presence/absence of early and late complications of surgical treatment, since they are the basis for inpatient stay or outpatient therapy.

The commission for obtaining disability is paid or not. And how much does it cost on average (if paid).

January 19, 2021, 07:36 Oleg, Moscow

Disability due to inflammation of the pancreas

Disability or permanent loss of ability to work due to pancreatitis is often established. This pathology is in 3rd place among all diseases of the digestive system that cause disability. Most patients, as a result of the initial examination (ISE), are immediately recognized as disabled people of the second group.

Is there any disability for chronic pancreatitis?

With a prolonged course of chronic pancreatitis in a patient (adult or child), ineffective treatment, and frequent exacerbations, the pancreas undergoes serious changes - the structure of the organ changes, its functions are disrupted to varying degrees.

The possibility of establishing disability appears with the development of diabetes mellitus and symptoms of exocrine insufficiency.

Disability due to pancreatic necrosis

Pancreatic necrosis is the destruction of gland tissue due to acute inflammation and the pathological effects of its own pancreatic enzymes. The development of this condition poses a serious threat to the patient’s life and requires immediate consultation with a surgeon and surgery (pancreatic resection). After this disabling operation, the patient is forced to take various medications for life as replacement therapy (constant insulin injections, enzyme preparations).

Such patients are required to undergo medical examination, determine the degree of disability and assign the appropriate disability group.

Criteria for establishing groups

The group for a patient with pancreatitis is established in accordance with the criteria prescribed in the current state legislative framework (Order 664/n of the Ministry of Labor and Social Protection of the Russian Federation, adopted in 2014).

First

The criterion for establishing a patient in the first group is the lack of normal legal capacity, disruption of the patient’s vital functions both due to intrasecretory pancreatic dysfunction and exocrine dysfunction of the affected organ.

In this case, the patient experiences such persistent (irreversible) types of disorders as:

• protein-energy malnutrition (PEM) in severe form;
• dysfunction of the normal process of food absorption.

Officially established disability for pancreatitis characterizes the patient as seriously ill, deprived of the ability to independently perform simple actions and operations for personal care, including going to the toilet, free movement and eating.

Second

The second group of pancreatitis is caused by a pronounced impairment of the patient’s ability to work due to protein-energy deficiency.

This condition is observed in patients whose pancreas is chronically inflamed. Cases of exacerbation of the disease occur 5-7 times in 12 months and are characterized by a long-term pain syndrome, which cannot be eliminated independently in the absence of emergency medical care, since this often causes internal bleeding, and medications do not have the desired therapeutic effect.

The patient's disability in such situations varies from 1 to 1.5 months.

The second disability group for pancreatitis is established if the patient has external, non-healing fistulas, as well as similar wounds that appeared after surgery, and there are false pancreatic cysts.

Third

The third group is established based on the results of an examination if the patient has digestive dysfunction, including problems with the functioning of the pancreas, which do not have a radical impact on his ability to work.

The medical history of the patient with the third group contains surgical interventions that did not entail any complications, as well as the presence of dysfunction of the diseased organ with clinical manifestations expressed in moderate or mild form.

Contraindicated types and working conditions

If a patient is given disability group 3, he is allowed to get a job with easy working conditions that suit him.

Places of work with certain characteristics of working conditions are contraindicated for disabled people:

Criteria for establishing disability groups

III disability group. Moderate disability is determined in the presence of the second stage of the disease, as well as in surgical treatment without complications, with a mild degree or absence of dysfunction of the gland. If rational employment is impossible without reducing the volume of production activities and reducing qualifications, in contraindicated professions.

Disability group II. A marked decrease in vital activity, detected in the third stage of the disease, characterized by frequent recurrent bleeding, the presence of pancreatic and external biliary fistulas after surgical treatment, with the ineffectiveness of intensive care, as well as in the presence of large pancreatic pseudocysts.

I disability group. A pronounced decrease in vital activity, which occurs with pronounced endocrine and exocrine dysfunction of the pancreas, with pronounced digestive dysfunction, nutritional dystrophy and cachexia, with the inability to independently care for oneself.

Reviews

Ekaterina, 36 years old, Vladimir: “My father had the third group for chronic pancreatitis. After the operation, his condition deteriorated sharply. He re-passed the ITU and received the second group. If things get worse, I advise you not to waste time, but to register complications with ITU doctors.”

Boris, 25 years old, Sevastopol: “They didn’t give my brother a group. The appeal was not accepted. The only way to appeal was through the courts.”

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A mild course is characterized by the fact that most patients retain professional ability to work.

However, this category of patients is contraindicated in labor processes that require severe physical stress and are associated with concussion and prolonged forced positioning of the body. In addition, contact with industrial hazards (benzene derivatives, metals and their compounds) is contraindicated. In cases where changes in conditions or types of work are carried out without reducing qualifications, the specified work restrictions are submitted to the medical and social expert commission.

Drawing conclusions

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